Welcome to the Conference Committee Registration Page for the 2013 Conference.

You must be a member of the CMC-South Conference Committee in order to use this registration page. Discounts included with this form are only available to committee members.

TWO-DAY CONFERENCE REGISTRATION (COMMITTEE MEMBERS ONLY)• $50 if registration and payment is received by October 1, 2013 (this is a discount of $145 off the regular fee)• $70 if registration and payment is received by October 15, 2013 (this is a discount of $125 off the regular fee)• $90 all registrations and payments received after October 15, 2013 (this is a discount of $105 off the regular fee)If you encounter any difficulties using this form or if you have any questions, please contact the registration Co-Chairs:

The registration process has two parts:INFORMATION: Complete the information part and then SUBMIT. You should receive immediate confirmation.PAYMENT:Your registration is not complete until payment is received. Directions for payment are at the bottom of this page.

ATTENTION REGISTRANT'S USING A PURCHASE ORDER:Before you begin the registration process you will need to provide additional information regarding the purchase order:• P.O. Number • Name of the contact person for purchase orders at your site or district • Contact person's e-mail • Contact person's work phoneIf you do not know the name of the purchase order contact person then provide the name and contact information for your principal or supervisor.

Registration Information (Part 1)

Step 1: Personal Information

* Indicates required field

Name *

First

Last

CMC Membership Number (if known): *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Registrant's Email *

Alternate Email *

Please provide at least one phone number where we can reach you if needed.

Step 2: Conference Registration

The cost for the Special Edition is $5.00. Do you wish to purchase a copy? *

YesNo

STEP 4: AFFILIATE MEMBERSHIP

Members of CMC are encouraged to become active members and participants in a local affiliate of CMC. Select one or more affiliates to become a member or to renew your membership.

Select one or more: *

Not at this timeAntelope Valley Mathematics Council = $10.00 per yearGreater Los Angeles Mathematics Council = $15.00 per yearGreater San Diego Mathematics Council = $15.00 per yearImperial County Mathematics Council = $10.00 per yearOrange County Mathematics Council = $10.00 per yearRiverside San Bernardino Counties Mathematics Teachers' Association = $10.00 per yearSan Gabriel Valley Mathematics Council = $10.00 per yearVentura County Mathematics Council = $10.00 per year

Step 5: Luncheons

Members of the Conference Committee receive a free ticket to their choice of either the Friday Leadership Luncheon or the Saturday Affiliate Luncheon.

The Friday Leadership Luncheon is open to all conference attendees and features guest speaker, Jo Boaler, Stanford University. The normal cost is $35.00 per person. The luncheon is held in the Pasadena and Madera Ballrooms at the Renaissance Hotel.

The Saturday Affiliate Luncheon is open to all conference attendees. The normal cost is $25.00 per person. Enjoy lunch and meet other attendees from your local area. The Affiliate Luncheon is held in the Pasadena and Madera Ballrooms at the Renaissance Hotel. (You may wish to purchase your Affiliate Luncheon ticket through your Affiliate. If that is the case then do not check the box below.

PAYMENT OPTIONS

MAIL-IN PAYMENT WITH CHECKThe check must contain the name of the person registering.CREDIT CARDCredit card payments are processed through PayPal. You are not required to have a PayPal account. Complete the form as a guest.PURCHASE ORDERSComplete the additional information requested below. You will need to provide the P.O. Number, the name of the contact person for purchase orders, the contact person's e-mail address and the contact person's work phone. If you do not know the name of the person in charge of purchase orders then submit the name and contact information for your principal or supervisor.

Please select your method of payment: *

Check (mail in the payment)Credit Card (process through PayPal)Purchase Order (submit a P.O. number and contact information)

PURCHASE ORDER INFORMATIONThe following information is requested for purchase order payments. If you are not paying by purchase order you may skip these next questions and proceed to the Submit section that follows.

Purchase Order Number *

Contact Person Name *

Contact Person E-mail *

Contact Person Phone *

SUBMIT TO COMPLETE REGISTRATION INFORMATION (PART 1)

Before you "Submit" your registration information you should print a copy for your records. You will not be able to make corrections to this form after the information is submitted. You will have to contact the Registrar directly to make any corrections.

After you submit your Registration Information (Part 1) you will then proceed to Payment (Part 2). Your registration is not complete until payment is received. Your payment must be received by the published deadlines for discounts to apply.

PAYMENT BY CHECKMake sure the name of the registrant appears on the check. You may also wish to submit a copy of your registration information form.CMC-SOUTH • Attn: E. Dixon/J. Sydner-Gordon • 335 E. Albertoni Street #200-552 • Carson, CA 90746

PAYMENT BY PURCHASE ORDERMake sure the name(s) of registrant(s) appear with the purchase order. Make sure that you have provided the P.O. Number, the name of the purchase order contact person, the contact person's e-mail and the contact person's work phone.

PAYMENT BY CREDIT CARDYour payment will be processed through PayPal. You are not required to have a PayPal account.

Your registration is not complete until your payment is received. Proceed to the Payment section below. To expedite your registration process and avoid delays make sure your selections below match your selections from Registration Information (Part 1). To qualify for available discounts make sure your payment is received by the due date.

CMC ComMuniCator Special Conference Edition

Affiliate Membership

Regional membership dues: Members of CMC are encouraged to become active members and participants in a local affiliate of CMC. Select this button to become a member or to renew your membership with one of the following southern California affiliates (Los Angeles and San Diego appear in the next payment box):Antelope Valley Mathematics CouncilImperial Valley Mathematics CouncilSan Gabriel Valley Mathematics CouncilRiverside/San Bernardino counties Mathematics CouncilVentura County Mathematics CouncilOrange County Mathematical Council

Affiliate Membership Greater Los Angeles Mathematics Council and Greater San Diego Mathematics Council

Members of CMC are encouraged to become active members and participants in a local affiliate of CMC. Select this button to become a member or to renew your membership with either the Los Angeles or San Diego affiliates.Greater San Diego Mathematics CouncilGreater Los Angeles Mathematics Council